Johns Hopkins Health Alert
What to Look For in a Prostate Cancer Surgeon
Dr. Patrick Walsh, former director of Hopkins’ Brady Urological Institute, shares his insights on choosing a doctor for your cancer surgery.
Dr. Patrick Walsh, dean of prostate cancer surgeons, has performed the technically challenging radical prostatectomy procedure thousands of times, and has personally schooled hundreds of surgeons in the finer points of the difficult nerve-sparing cancer operation. He certainly knows what it takes to be an expert in curing a man of cancer, preserving bladder function, and maintaining the nerves responsible for erections. What about the doctor you’re considering for your own prostate cancer surgery?
"Your doctor may be nice and personable,” says Dr. Walsh,"a practitioner whose empathy for your condition appeals to you, which is great. But what do you know about him? He’s got a terrific bedside manner, but is he a board-certified urologist? What training has he had? Does he know and use the nerve-sparing cancer surgery techniques -- the anatomical approach to radical prostatectomy? How many of these cancer surgeries does he perform annually? What success has he had in preserving potency and continence? If he can’t or won’t give you his rate of success as compared to reports from other surgeons, or to results published in medical journals, this may be a red flag, and perhaps you should look elsewhere for your cancer surgeon.
"You should be able to get a good idea of his success rate in numbers or percentages. In addition, if he hasn’t done very many of these cancer operations -- ideally, hundreds -- you might want to find a more experienced surgeon. Look at it this way: Do you want to be one of the patients he’s learning on? Do you want to be part of someone’s learning curve?
"Remember: You don’t want a surgeon who’s 'pretty good’ at removing the prostate. There are no second chances here: This is a one-shot operation. You are looking for the one surgeon who will perform the one radical prostatectomy you will ever receive in your life, the one operation that will cure your cancer.
"You want a surgeon who is going to make sure that no cancer is left behind, and who knows how to minimize trauma to your body during surgery so you don’t wind up with incontinence, erectile dysfunction, or both.
"Finding the right surgeon may mean that you must travel to a major medical center in another city. This may mean that you’ll be away from home for four days. But after that, even though you may need to wear a catheter for a week or two, the recovery from the operation is usually speedy, and follow- up communication can be carried out over the telephone.
Posted in Prostate Disorders on October 11, 2007
Reviewed September 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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OK, now tell us how we can find this information out?
Posted by: Anita Sedler | October 19, 2008 7:44 AM
I have a history over some 8 years of PSA scores. All have remained below the 1.2 level. During an examination, the doctor was concerned about a small area of hardness in the prostate. After a biopsy, I was informed that my Gleason score was 6. Another PSA six months after the biopsy had not changed. Another PSA this past month had changed to 1.3. At 71 years of age, what would you suggest?
Posted by: Pfeffer | January 6, 2009 4:31 PM
Great Forum, however, you've neglected to even mention probably the most successful type of Prostate surgery and that's the Robotic Prostatectomy Surgery as performed by Dr. Patel of the Global Robotics Institute in Celebration, FL and others. I just returned from a successful procedure this week (3/24/09) and had the catheter removed in 4 days, more than 90% urinary tract continence, normal sexual function almost immediately (even though I'm not to have sexual activity for 4 weeks per the doctor). The Robotic technique is absolutely the "Least" invasive of all the current techniques. I was up walking comfortably in less than 12 hours after the surgery. Only 5 small incisions in your lower torso is all that indicates I even had the surgery just (1) week ago! In addition, Dr. Patel's staff is amazing (no, I'm not paid to say this!), including the erectile dysfunction assistant. The DaVinci Robot uses 10X magnification, 3D imagery, and all in HD video and Dr. Patel actually works at a console and the robot does all the work with more precision than any human can even dream of. Check it out, I'm a survivor at 56 years of age who had a very large tumor!!! Brad
Posted by: bkimes | March 28, 2009 9:31 PM
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Where can this information on the number of proceedures and the success rate of a doctor be found. I've never had a doctor quote anything other than the overall average success rate for a proceedure.
Posted by: blkan | October 11, 2007 5:04 PM